{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T08:25:52Z","timestamp":1774340752802,"version":"3.50.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Objectives Contemporary electronic health records (EHRs) offer a wide variety of features, creating opportunities to influence healthcare quality in different ways. This study was designed to assess the relationship between physician use of individual EHR functions and healthcare quality.<\/jats:p><jats:p>Materials and Methods Sixty-five providers eligible for \u201cmeaningful use\u201d were included. Data were abstracted from office visit records during the study timeframe (183 095 visits with 61 977 patients). Three EHR functions were considered potential predictors: acceptance of best practice alerts, use of order sets, and viewing panel-level reports. Eighteen clinical quality measures from the \u201cmeaningful use\u201d program were abstracted.<\/jats:p><jats:p>Results Use of condition-specific best-practice alerts and order sets was associated with better scores on clinical quality measures capturing processes in diabetes, cancer screening, tobacco cessation, and pneumonia vaccination. For example, providers above the median in use of tobacco-related alerts had higher performance on tobacco cessation intervention metrics (median 80.6% vs. 66.7%; P &amp;lt; .001), and providers above the median in use of diabetes order sets had higher quality on diabetes low density lipoprotein (LDL) testing (68.2% vs. 59.5%; P == .001). Post hoc examination of the results showed that the positive associations were with measures of healthcare processes (such as rates of LDL testing), whereas there were no positive associations with measures of healthcare outcomes (such as LDL levels).<\/jats:p><jats:p>Discussion Among primary care providers in the ambulatory setting using a single EHR, intensive use of certain EHR functions was associated with increased adherence to recommended care as measured by performance on electronically reported \u201cmeaningful use\u201d quality measures. This study is relevant to current policy as it uses quality metrics constructed by contemporary certified EHR technology, and quantitative EHR use metrics rather than self-reported use.<\/jats:p><jats:p>Conclusion In the early stages of the \u201cmeaningful use\u201d program, use of specific EHR functions was associated with higher performance on healthcare process metrics.<\/jats:p>","DOI":"10.1093\/jamia\/ocv030","type":"journal-article","created":{"date-parts":[[2015,4,21]],"date-time":"2015-04-21T02:02:05Z","timestamp":1429581725000},"page":"864-871","source":"Crossref","is-referenced-by-count":48,"title":["Associations between healthcare quality and use of electronic health record functions in ambulatory care"],"prefix":"10.1093","volume":"22","author":[{"given":"Jessica S","family":"Ancker","sequence":"first","affiliation":[{"name":"Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA"},{"name":"Health Information Technology Evaluation Collaborative (HITEC), New York, NY, USA"}]},{"given":"Lisa M","family":"Kern","sequence":"additional","affiliation":[{"name":"Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA"},{"name":"Health Information Technology Evaluation Collaborative (HITEC), New York, NY, USA"}]},{"given":"Alison","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA"},{"name":"Health Information Technology Evaluation Collaborative (HITEC), New York, NY, USA"}]},{"given":"Sarah","family":"Nosal","sequence":"additional","affiliation":[{"name":"Institute for Family Health and the Mount Sinai Department of Family Medicine and Community Health, New York, NY, USA"}]},{"given":"Daniel M","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA"}]},{"given":"Diane","family":"Hauser","sequence":"additional","affiliation":[{"name":"Institute for Family Health and the Mount Sinai Department of Family Medicine and Community Health, New York, NY, USA"}]},{"given":"Rainu","family":"Kaushal","sequence":"additional","affiliation":[{"name":"Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA"},{"name":"Health Information Technology Evaluation Collaborative (HITEC), New York, NY, USA"}]},{"name":"with the HITEC Investigators","sequence":"additional","affiliation":[]}],"member":"286","published-online":{"date-parts":[[2015,4,20]]},"reference":[{"key":"2020110613030499800_ocv030-B1","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1056\/NEJMp1006114","article-title":"The \u201cmeaningful use\u201d regulation for electronic health records","volume":"363","author":"Blumenthal","year":"2010","journal-title":"New Engl J Med."},{"key":"2020110613030499800_ocv030-B2","first-page":"1","article-title":"Trends in electronic health record system use among office-based physicians: United States, 2007-2013","volume":"75","author":"Hsiao","year":"2014","journal-title":"Natl Health Stat Reports."},{"issue":"10","key":"2020110613030499800_ocv030-B3","doi-asserted-by":"crossref","first-page":"742","DOI":"10.7326\/0003-4819-144-10-200605160-00125","article-title":"Systematic review: Impact of health information technology on quality, efficiency, and costs of medical care","volume":"144","author":"Chaudhry","year":"2006","journal-title":"Ann Int Med."},{"issue":"7","key":"2020110613030499800_ocv030-B4","doi-asserted-by":"crossref","first-page":"482","DOI":"10.7326\/0003-4819-157-7-201210020-00004","article-title":"Outpatient electronic health records and the clinical care and outcomes of patients with diabetes mellitus","volume":"157","author":"Reed","year":"2012","journal-title":"Ann Int Med."},{"issue":"18","key":"2020110613030499800_ocv030-B5","doi-asserted-by":"crossref","first-page":"2305","DOI":"10.1001\/jama.294.18.2305","article-title":"Clinical decision support and appropriateness of antimicrobial prescribing: a randomized trial","volume":"294","author":"Samore","year":"2005","journal-title":"JAMA."},{"issue":"4","key":"2020110613030499800_ocv030-B6","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1007\/s11606-012-2237-8","article-title":"Electronic health records and ambulatory quality of care","volume":"28","author":"Kern","year":"2013","journal-title":"J Gen Intern Med."},{"issue":"3","key":"2020110613030499800_ocv030-B7","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1097\/MLR.0b013e3181c16203","article-title":"Relationship between use of electronic health record features and health care quality: results of a statewide survey","volume":"48","author":"Poon","year":"2010","journal-title":"Med Care."},{"issue":"2","key":"2020110613030499800_ocv030-B8","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1001\/archinternmed.2008.520","article-title":"Clinical information technologies and inpatient outcomes: a multiple hospital study","volume":"169","author":"Amarasingham","year":"2009","journal-title":"Arch Int Med."},{"issue":"6","key":"2020110613030499800_ocv030-B9","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1136\/amiajnl-2013-002627","article-title":"How is the electronic health record being used? Use of EHR data to assess physician-level variability in technology use","volume":"21","author":"Ancker","year":"2014","journal-title":"J Am Med Inform Assoc."},{"issue":"1","key":"2020110613030499800_ocv030-B10","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1136\/amiajnl-2012-001377","article-title":"Understanding differences in electronic health record (EHR) use: linking individual physicians\u2019 perceptions of uncertainty and EHR use patterns in ambulatory care","volume":"21","author":"Lanham","year":"2014","journal-title":"J Am Med Inform Assoc."},{"issue":"4","key":"2020110613030499800_ocv030-B11","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1055\/s-0038-1634221","article-title":"ICT in health care: sociotechnical approaches","volume":"42","author":"Berg","year":"2003","journal-title":"Meth Inform Med."},{"key":"2020110613030499800_ocv030-B12","author":"Armijo"},{"key":"2020110613030499800_ocv030-B13","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1472-6947-6-3","article-title":"IT adoption and the interaction of task, technology and individuals: a fit framework and a case study","volume":"6","author":"Ammenwerth","year":"2006","journal-title":"BMC Med Inform Decis Mak."},{"key":"2020110613030499800_ocv030-B14","first-page":"749","article-title":"The triangle model for evaluating the effect of health information technology on healthcare quality and safety","volume":"18","author":"Ancker","year":"2011","journal-title":"JAMIA."},{"key":"2020110613030499800_ocv030-B15"},{"issue":"3","key":"2020110613030499800_ocv030-B16","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1287\/isre.1060.0096","article-title":"Reconceptualizing system usage: an approach and empirical test","volume":"17","author":"Burton-Jones","year":"2006","journal-title":"Inform Sys Res."},{"issue":"5","key":"2020110613030499800_ocv030-B17","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/00005650-199105000-00006","article-title":"Development and application of a population-oriented measure of ambulatory care case-mix","volume":"29","author":"Weiner","year":"1991","journal-title":"Med Care."},{"issue":"1","key":"2020110613030499800_ocv030-B18","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the false discovery rate: a practical and powerful approach to multiple testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J R Stat Soc, Series B."},{"issue":"13","key":"2020110613030499800_ocv030-B19","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1056\/NEJMsa010181","article-title":"A computerized reminder system to increase the use of preventive care for hospitalized patients","volume":"345","author":"Dexter","year":"2001","journal-title":"New Engl J Med."},{"issue":"12","key":"2020110613030499800_ocv030-B20","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1001\/archinte.163.12.1409","article-title":"Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review","volume":"163","author":"Kaushal","year":"2003","journal-title":"Arch Intern Med."},{"issue":"SP","key":"2020110613030499800_ocv030-B21","first-page":"SP88","article-title":"The comparative effectiveness of 2 electronic prescribing systems","volume":"17","author":"Kaushal","year":"2011","journal-title":"Am J Manag Care."},{"issue":"6","key":"2020110613030499800_ocv030-B22","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1007\/s11606-009-1238-8","article-title":"Electronic prescribing improves medication safety in community-based office practices","volume":"25","author":"Kaushal","year":"2010","journal-title":"J Gen Int Med."},{"issue":"1","key":"2020110613030499800_ocv030-B23","first-page":"41","article-title":"Viewpoint: controversies surrounding use of order sets for clinical decision support in computerized provider order entry","volume":"14","author":"Bobb","year":"2007","journal-title":"JAMIA."},{"issue":"3","key":"2020110613030499800_ocv030-B24","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1097\/CCM.0b013e318196206b","article-title":"Hospital-wide impact of a standardized order set for the management of bacteremic severe sepsis","volume":"37","author":"Thiel","year":"2009","journal-title":"Crit Care Med."},{"issue":"6","key":"2020110613030499800_ocv030-B25","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1093\/intqhc\/mzq051","article-title":"Impact of a standardized heart failure order set on mortality, readmission, and quality and costs of care","volume":"22","author":"Ballard","year":"2010","journal-title":"Intern J Qual Health Care."},{"issue":"10","key":"2020110613030499800_ocv030-B26","first-page":"256","article-title":"Effect of a patient panel-support tool on care delivery","volume":"16","author":"Feldstein","year":"2010","journal-title":"Am J Manag Care."},{"issue":"12","key":"2020110613030499800_ocv030-B27","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1097\/MLR.0b013e31817e18ae","article-title":"Electronic health record components and the quality of care","volume":"46","author":"Keyhani","year":"2008","journal-title":"Med Care."},{"issue":"8","key":"2020110613030499800_ocv030-B28","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1001\/2013.jamainternmed.61","article-title":"Information overload and missed test results in electronic health record\u2013based settings","volume":"173","author":"Singh","year":"2013","journal-title":"JAMA Int Med."},{"issue":"9302","key":"2020110613030499800_ocv030-B29","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/S0140-6736(02)07451-2","article-title":"Bias and causal associations in observational research","volume":"359(","author":"Grimes","year":"2002","journal-title":"Lancet."},{"issue":"8","key":"2020110613030499800_ocv030-B30","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1136\/jech.2003.008466","article-title":"Bias","volume":"58","author":"Delgado-Rodr\u00edguez","year":"2004","journal-title":"J Epidemiol Community Health."},{"key":"2020110613030499800_ocv030-B31","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1111\/j.1464-5491.2008.02544.x","article-title":"Introduction of a new incentive and target-based contract for family physicians in the UK: good for older patients with diabetes but less good for women?","volume":"25","author":"McGovern","year":"2008","journal-title":"Diabetic Med."},{"key":"2020110613030499800_ocv030-B32","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1093\/fampra\/cmm073","article-title":"The effect of the UK incentive-based contract on the management of patients with coronary heart disease in primary care","volume":"25","author":"McGovern","year":"2008","journal-title":"Fam Pract."},{"key":"2020110613030499800_ocv030-B33","doi-asserted-by":"crossref","first-page":"549","DOI":"10.7326\/0003-4819-147-8-200710160-00007","article-title":"Quality improvement with an electronic health record: Achievable, but not automatic","volume":"147","author":"Baron","year":"2007","journal-title":"Ann Int Med."},{"key":"2020110613030499800_ocv030-B34"},{"issue":"2","key":"2020110613030499800_ocv030-B35","doi-asserted-by":"crossref","first-page":"77","DOI":"10.7326\/0003-4819-158-2-201301150-00001","article-title":"Accuracy of electronically reported \u201cmeaningful use\u201d clinical quality measures: A cross-sectional study","volume":"158","author":"Kern","year":"2013","journal-title":"Ann Int Med."},{"issue":"4","key":"2020110613030499800_ocv030-B36","first-page":"604","article-title":"Validity of electronic health record-quality measurement for performance monitoring","volume":"19","author":"Parsons","year":"2012","journal-title":"JAMIA."}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/22\/4\/864\/34146472\/ocv030.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/22\/4\/864\/34146472\/ocv030.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T14:15:19Z","timestamp":1717856119000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/22\/4\/864\/1746441"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,20]]},"references-count":36,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2015,4,20]]},"published-print":{"date-parts":[[2015,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocv030","relation":{},"ISSN":["1527-974X","1067-5027"],"issn-type":[{"value":"1527-974X","type":"electronic"},{"value":"1067-5027","type":"print"}],"subject":[],"published-other":{"date-parts":[[2015,7]]},"published":{"date-parts":[[2015,4,20]]}}}